Radical Psychology
2007, Volume Six, Issue 1



‘Oh, Jo! You can’t see that real life is not like riding a horse!’: Clients’ constructions of power and metaphor in therapy

Dafni Milioni

Introducing the Research. [1]

This paper is based on my Ph.D thesis looking into 'clients' and 'therapists' constructions of metaphor and metaphor use in therapy. The research itself involved a version of discourse analysis of accounts that resulted from a number of semi-structured interviews with participants, as well as from the transcript of a focus group. I recruited a total of 16 participants (12 women and 4 men), 8 of those were therapists, including a Dramatherapist and 5 were clients to therapy. An additional three participants were recruited for occupying the double positioning of 'therapist in training' and 'client' to therapy (i.e. hence having access to discourses from both positionings) and took part in a focus group with the aim of exploring meaning construction in action. All names that are included in the excerpts in this paper are pseudonyms, in no way indicative of ethnic origin. The decision to recruit a Dramatherapist reflects my personal interests and familiarity with the field and was aimed at exploring dominant discourses in this area, while in no way implying the account is 'representative' of Dramatherapists. Participants were recruited solely on the basis of their availability. Categories were in all avoided, unless as made relevant by the participants themselves in talk (e.g. model of practice, ethnicity). I did however make an effort to represent a wide range of therapeutic discourses, through recruiting therapists from as wide a range of models of practice as possible. Models represented were various constellations grouped under an Integrative or Eclectic approach (e.g. combinations of existential, Cognitive Behavioural Therapy, cognitive, Cognitive Analytic Therapy, person-centred, psychodynamic, Jungian, systemic, humanistic, core theory), as well as the psychoanalytic approach. A number of therapists were recruited from two NHS Trusts. Due to the nature of the topic, an attempt was made to recruit experienced therapists, where possible, to counter-balance issues such as the novelty of the practitioner or a lack of familiarity with metaphor in therapy and its uses, both of which may impact on the richness of data. I therefore approached a number of experienced former colleagues, who I knew had an interest in metaphor. This was an attempt to ensure that data would be sufficiently rich by only including practitioners with an expressed interest in metaphor work in therapy. I used a 'snowballing' technique, where the research was advertised by word of mouth. Clients were recruited in four ways: 1) via posters placed in the psychology department at City University aimed at students training in Counselling Psychology on the MSc. and Post-MSc. courses (i.e. for the dual positioning of client/therapist focus group). 2) I also placed advertisements in alternative health centres in my local area, which offered counselling and/or psychotherapy. 3) I circulated the advertisement via the email list of the Critical Mental Health Forum group, notifying participants to the Forum of my research.

Utilising a critical realist and constructionist perspective, where no claims as to the ontological status of metaphor were made, I was instead interested in the participants' discursive resources in accounting for the phenomenon of 'metaphor' and 'metaphor in therapy'. In order to achieve this I conducted a number of semi-structured interviews with therapists and clients to therapy, interviewed separately, as it had not been possible, for ethical approval reasons, to work with interactional data (i.e to conduct interviews where therapists and clients discussed metaphor together). The purpose of these interviews was to collect discursive accounts that pertained to multiple constructions of metaphor and other discursive considerations, such as the discursive and rhetorical strategies participants enlisted. In addition, I wanted to explore the subjectivities of the clients in relation to metaphor use in their therapy. In order to make up in part for the lack of interactional data and to observe co-construction of meanings in action, I ran a focus group in which participants were invited to contribute their views from a double position of being both 'therapists in training' and having been 'clients' to therapy at some point in their lives. Fourteen texts were subsequently transcribed in a style that emphasises readability rather than intonation.


Analysis of texts


The discourse analytic method represented an analytic decision based on differing research interests in terms of each research group (therapists and clients) and it was finally crystallized in the research as representing a difference in emphasis between the two methods employed. In discursive psychology, the focus of the analysis is on the fine grain rhetorical functions of the discourse-how people use language and what is accomplished by the employment of certain discursive strategies (e.g. disclaiming, footing, extreme case formulation etc.). Attention is therefore paid to the action orientation of talk, which represents multiple ways of reading talk (e.g. Edwards, 1997; Edwards and Potter, 1992). The context is always of paramount importance (i.e. readings are local). For example, variability in one account in terms of interpretative repertoires, suggests that objects are constructed through language and that discourses are inherently dilemmatic (Willig, 2000). In the therapist's accounts, the focus was therefore on the functions performed by language, under the assumption that there is 'stake' in the way the therapists are positioned by the interviewer in relation to the topic of metaphor use in therapy (an 'expert' positioning). As a result the action orientation of the texts was explored, as well as the rhetorical effects of language. The only exception to this was the Dramatherapist's interview, which, being more of a narrative (monologue) was also analysed with a Foucauldian emphasis. Foucauldian discourse analysis is more reconcilable with an applied framework. For the client's accounts, the Foucauldian version permitted an exploration of the extent to which expert therapist discourses were affirmed, resisted or altered by clients. It also enabled the exploration of multiple and varied constructions of metaphor' and constructions of subject positions. In addition, some of the resulting political, theoretical and applied implications were considered. Finally, the focus group's combined version looked into all of these analytic aspects.


Overview

'Power' in discursive psychology is dually theorised as the pre-discursively defined inequality of relations such as in the case of institutions (i.e. institutional power) and as an interactional quality through the strategic employment of discursive strategies (Jaworski and Coupland, 1999). The concept of power is also particularly compatible with a Foucauldian approach to discourse analysis, which suggests that institutions, like therapy and mental health organisations are structured around and reproduce power relations (Parker, 1992). As Harper puts it: "it's about who gets to speak and who gets to choose the words we use to talk about madness" (2002a, p. 9). Another view that is currently challenged is that any therapy talk is helpful. Talk can just as easily be oppressive rather than liberating or helpful if it is the wrong kind of talk, in other words if it is pathologising or blaming (Harper, 2002b). Metaphor as an inextricable feature of talk potentially has the same implications. Power inequality as an inherent aspect of the therapeutic relationship is now widely accepted. As such, it cannot be denounced, but must be linked to responsibility. In White and Epston's (1990) words:

If we accept that power and knowledge are inseparable [ ] and
if we accept that we are simultaneously undergoing the effects
of power and exercising power over others, then we are unable
to take a benign view of our practices. [ ] Instead, we would assume
that we are always participating simultaneously in domains of
power and knowledge (p.9).


The empowerment of the client, as the realisation of the capacity for oppressed groups to have access to power (Bhavnani, 1990), is therefore an important task for therapy. Anderson and Goolishian (1992), for example have tried to redress the balance by advocating a way of working where the client is seen as the expert in their own experience (also Anderson, 1997) and Narrative Therapy also denounces the 'knowing expertise' of the therapist (e.g. White and Epston, 1990; Cheshire et al., 2004). As certain discursive and signifying practices perpetuate positionings that compromise the client's egalitarian position, it is only by becoming aware of power issues in therapeutic practice that we can strive towards a politically aware [2] and ethical practice. It is also noteworthy that, as some client participants to this research suggested, therapists can be themselves oppressed by institutions and practices over which they have little control. This point is made in the following client quote:

it [using metaphor] was one of the best parts, because she was
giving, she seemed to be free to give more. The rest of the time
I felt her technique inhibited her because she wasn't allowed to be
too human (Rhona, 467-470). [3]


A Discursive Psychology approach to the material would have also been possible. From this perspective, clients' constructions of power could have been understood, for example, as disclaiming devices for personal agency and responsibility. Instead, my interest lay in exploring the extent to which clients' discourses affirmed those of the therapists or whether they diverged from them. For this reason, I want to emphasise here that the status of the texts has a realist ontology, as client accounts are taken at face value, as authored accounts of self-expression (Willig, 2004), in order to explore issues of power in therapy.

Constructing metaphor and power in therapy


In the examples that follow, clients construct metaphor in ways that have political implications and explain how certain uses of metaphor by the therapist work as metaphors for power positions. For example a particular physical set up of the therapy space, certain scripted behaviours and institutional practices only enable certain positionings for client and therapist and restrict access to others.


Power-laden uses of metaphor


a) Using metaphor as a silencing device

Clients described the therapist using a client- or therapist-generated metaphor in a way that acted as a silencing device for the client. In these cases, the client's worldview was closed down and denied in favour of the therapist's (e.g. 'can't you see that real life is not like riding a horse?'). In this way, the therapeutic relationship is itself constructed as a power struggle, like a game of 'tug of war'. In the first excerpt, the client, Jo, uses 'riding a horse' as a metaphor for life. She describes her therapist's response as un-helpfully obliterating that metaphor and worldview in favour of an alternate perspective, that of the therapist's:

because I go horse riding sometimes, I would
make a lot of references and comparisons to
horses and images to do with the riding [ ] and
I was using an image like that to explain it's just
like you have to keep at something, you can't
give up and she said 'oh!' and she then got really
exasperated with me, she said 'oh, Jo!' she said,
'you can't see that real life isn't like riding a horse!'
and I said 'yes it is, it is like riding a horse, it is
exactly like riding a horse! (Jo, 306-314).


b) The high-jacked metaphor


Client-generated metaphors were at times constructed as 'high-jacked' by the therapist, who put a different meaning on them. Below, Linda draws on a discourse of ownership ('that's mine, give it back'). Her positioning as a helpless child also evokes a family discourse. She uses action verbs ('taking your metaphor and running away with it') to describe how metaphor is snatched way from her like an object, while she positions herself as passive in the interaction. Her only reaction is to shout back ('Come back! That's mine!'), as she represents herself as incapable of reclaiming the object (i.e. metaphor). Instead, she has to plea for its return. The extract evokes playground bullying. She portrays this use of metaphor by the therapist as power-driven and unhelpful:


it's also something about getting back in contact with that
feeling of [ ] taking your metaphor and running away with it
(laughs) in a completely different direction, it's like 'Come
back, that's mine! Give it back! (laughs) I had plans for that
one!' and making sure that I don't do that to clients
(LindaFG [4], 1166-1174).


The example below positions the therapist as powerful, in that he or she has the right to ask probing questions. The legitimisation of probing questions by the therapist, in turn positions the client in a pathologising way, a position she then has to work hard to defend against and denounce:

I was trying to describe really different moods and I was using
kind of different people's names to describe them and [ ] I can't
remember what I called them, sort of Mister G and different
names and Mister Whirly Dervish or whatever but then my
therapist started asking probing questions as if 'are you
psychotic? Are you losing your mind?' (joint laughter) and that
felt really unhelpful and I hadn't meant it in that way whatsoever
(LindaFG, 962-974).


c) The signifying environment


The arrangement of the therapy environment and certain institutional practices like note-taking, act as meta-communicators and specify particular power relations between therapist and client, which govern and regulate the nature of the interaction by making only certain positionings possible. Furthermore, these discursive practices produce and re-produce these rules. In the first example below, a client describes, how the set up of the therapy room already positions the therapist as 'expert' and 'powerful' and the client as 'passive' or 'emotional' by describing the room furniture not as arbitrary arrangements, but as powerful signifiers of specific power positionings. For example, by having a bookcase behind the therapist (knowledge and power) and a box of tissues and a bin (a receptacle perhaps for emotional rubbish) next to the client. The client describes this as a dictation of the role she is expected to take ('I'm supposed to sit there and cry'):

I didn't like the way I went into the room and she had on her side
of the room this bookcase with all these books in it and on my
side of the room I had this box of tissues and a bin (joint laughter)
and I didn't like it and what was worse was that the box of tissues
was like there was the top tissue was really pulled up at this sort of
like pyramid [ ] it was like telling me that I'm supposed to sit there and
cry' (Jo, 415-420).


In the second example, again the physical space and the objects contained within it spell out the differences between therapist and client: the therapist is obviously affluent, the client by implication is forced into a comparison through which she emerges as disadvantaged. The use of 'ostensibly' is pivotal here in establishing a conscious and perhaps intentional display of power positionings for therapist and client. Other elements also act as signifiers such as the therapist's clothes:


first of all I didn't like the fact that I went to her house. That
made mefeel at a great disadvantage and did the therapy in
her husband's room where his golfing pictures were up and I
didn't like that. And she was also very well heeled and very
well off or you know, relatively, ostensibly, ostensibly and I
didn't like that cause I was at a stage where I was losing
everything and having to move out and everythingand I just felt
annoyed at that (laughs). I felt disadvantaged (Rhona, 525-531).


The client from the first example, however, constructs herself as 'reactive' to this physical arrangement of the space and the power positions it spells out, by refusing to cry and by having an urge to upset this status quo:

I didn't want to do that, it made me angry and I really was
determined not to do that, I didn't do it at all and there was
this bin as well. It was always, I was the first client in and I
always had a clean bin liner in and I felt this need to throw
some rubbish in it (Jo, 420-424).


She further constructs herself as 'assertive', as an educated person. She is able to stand up for herself, question the positionings and the input of the therapist. She describes this position as a 'challenge' or 'threat' to the therapist. It is possible, therefore, to challenge power positionings and to reclaim some of that power, but it takes an assertive, secure and educated person to do so:


I had some power in that I think I am an assertive
person and I am studying and feel I am generally
quite confident. I think that may have been a problem
to her, I don't know (Jo, 413-415).


Oppressive practices


Another form of exerting power in therapy is on an institutional level. Clients referred to the following means of power-exertion, which have become routine means of control of the client and the process of therapy (i.e. they are normalised in therapy contexts as part of the process of therapy in organisations, a kind of 'natural order of things' argument):

i)    scripted behaviour

ii)    note-taking and

iii)    withholding

'Withholding' refers to those styles of therapy, usually described in psychodynamic approaches that advocate the therapist's role as that of a 'blank slate' for the client to project onto. These approaches also tend to favour a low level of personal disclosure on the part of the therapist.


a) Scripted behaviour


Clients constructed certain rules that seem to govern interaction in a therapy context as oppressive. This includes the therapist 'going to fetch' the client (a common practice in counselling within institutions) and leading the way to the counselling room. This scripted behaviour was described as 'unnatural' and 'restrictive'. The power is also firmly placed in the hands of the therapist as the initiator of the therapy interaction:

I'd have to follow her single-file down this corridor and
she'd never speak to me and we'd go into the room [ ]
and she'd nod at me to speak, she would never ever
say hello or anything like that and I really hated that
there were no pleasantries at all (Jo, 357-361).


Perhaps it is a useful point for reflection, the implication that what counselling psychology constructs and normalises as giving 'permission to cry' or not establishing conversation with the client outside the therapy room as 'demarcation of the therapy space', are instead constructed by clients as oppressive practices.

b) Note-taking

Note-taking, though not uncommon in therapy, is constructed here by clients as another form of oppressive practice. Notes represent a fixed sort of narrative, that is 'there' and which can have damaging implications (i.e. different sorts of people might see it, it cannot be altered, the client has limited or no access to it and doesn't have a say in it, etc.). In the first excerpt, Jay makes a dichotomy of power, between doctors (referring to a psychiatrist) and clients. The former are 'all-powerful', the latter 'nobodies'. This is a clear example of what Potter (1996) calls 'category entitlements', by which speakers invoke membership to a particular category when building up an account as sufficient to warrant category-specific knowledge (sometimes they are not 'natural' but need to be 'achieved' or 'worked up'). In this case to be a doctor equals power, to be a client equals being powerless. Access to notes is only restricted to the doctors and the therapeutic relationship is therefore constructed as un-equal:

I feel that behind my back they write reports. I feel [ ]
I should read the reports. I'm not a doctor, I'm nobody
[ ] remember they are the most powerful people, well
not the most powerful, but they have, what they say
counts more than I do. Remember, I'm just a client
(Jay, 494-512).


Below, Rhona also refers to note-taking, therapy in the therapist's own house, as well as therapeutic techniques as patronising, since the client is positioned on unequal footing and can also perceive therapeutic techniques, described here as a sort of object-oriented experimentation ('she was using a technique to see what I would do'):

[researcher] so how much power did you feel you had?


[Rhona] not much, no, no. I felt that the fact of going to
her house and her making these notes and having this
technique that she would know she was using a technique
to see what I would do [ ] I would rather see things more
above the board than that really (Rhona, 545-548).


c) Withholding


Clients also constructed a helpful therapist to be 'directive', as opposed to 'withholding'. The latter was referred to as an unwanted and alienating feature of therapy. This referred specifically to therapists who 'sat back' and it was "like to just talk to a blank" (Rhona, 535). By contrast, metaphor is described as a realm where a 'real meeting' can take place:

before then she seemed to be withholding, it was a
technique and the method I found that a rather sort of
rejecting thing to be with someone who just sits back
and expects you to do all the projecting and everything.
I like to meet people and I felt that we could meet in the
realm of metaphor and still be discussing deep things
but in a safer sort of way (Rhona, 152-156).


In the next example, the 'withholding therapist' is constructed as antagonistic, while the client becomes 'reactive' through the use of silence (see section on clients 'acts of resistance') and the relationship is described as reaching an impasse. The content, however, is contradictory. While the client seems to be saying she does not want guidelines or answers, she does want something challenging:

I remember my therapist, you know, it was like half an hour
of the session and we were just staring at each other and it
was like "I'm not gonna say anything until she says something",
you know. I had gone in angry and she said to me "I'm not
going to make things easy for you. If you wanna say something,
you say it, if you don't want to one hour will pass and, you know,
you don't have to say anything". I've started to believe that I don't
like this sort of approach, I don't know whose approach it is but
(laughs) I don't like it that much. Maybe it's a right one, but I don't
want help or guidelines or answers. I would have liked more of a
challenge so I say things (Elaine, 556-564).


In the next excerpt, Elaine, in talking about her experience with her two Dramatherapists, raises an interesting point about the counter-intuitive ways in which 'giving direction' ("they gave the instructions, now you do this scene, now you do that scene", Elaine, 405) is equated with equality (c.f. doing nothing with power):

I saw the therapists as part of the group, not as away from the group like I do the therapists now (Elaine, 351-2)


Where the therapist was described as 'withholding', the client's metaphor was also described as 'wasted'. Here, Jo describes how the metaphor she used in one session was ignored, only to be referred to again by the therapist in the next session, by which time Jo felt the metaphor had been 'wasted':

so she didn't really give me any feedback from that and then
the next week she said 'oh I understand what you mean about
the volcanic island' and she told me back exactly what I sort of
thought I'd said to her [ ] but it was wasted the following week
cause I had known that anyway and that was what I felt was like
a bit of a time lapse between me saying something and [


[researcher]: the feedback that she gave' (Jo, 101-108).


The 'unspoken metaphor'


The 'client' was occasionally described as 'circumspect' in relation to the use of metaphor. This construction is particularly evident in Jo's interview. Particularly, where the therapist's knowledge of the client's history of 'psychiatric illness' is concerned:

whenever I raised these images I always thought that maybe
she did think that that was unacceptable, you know, because
I had been in a psychiatric unit and I thought that maybe she'd
think oh, you know, that's like a crazy thing to be talking about
(Jo, 280-283).


Where metaphors were judged by the client to be 'out of the norm', 'disturbing' or 'bizarre', they were withheld and not shared with the therapist. Similarly to the withholding therapist, the client also becomes withholding. The judgement of metaphor was done by reference to 'normality' and to everyday 'conversations':

normally, in real life conversation, you don't talk about birds
in thorn bushes or you don't talk about coral islands and
volcanoes or darkness and the images when you've got
disturbing images you don't talk [about them] (Jo, 515-518).


Jo constructs a 'timeliness' of metaphor as important for metaphor work. Indeed, she suggests that a metaphor that is not taken up in the moment is a wasted metaphor. She further suggests that for the therapist to merely repeat the client's metaphor without exploring possible meanings is also a waste ('I had known that anyway').


Acts of resistance

Clients positioned themselves in talk as both 'helpless' and 'assertive'. For example, they represented themselves as 'helpless' when they were fighting over ownership of metaphor (as in the section 'the hijacked metaphor') and associated meanings, but also as 'assertive' by attempting to resist unequal positionings in the therapeutic encounter. Simpson (1977) states that while individuals can be forced to conform to specific forms of behaviour, there are still "possibilities for resistance" (p. 221) The latter positioning is demonstrated in the interaction between two members of the focus group (therapists in training but also clients to therapy) that follows, who speak from a client's position:

so for me the use of metaphor would be more useful
than not useful because I would sort of stop my therapist
and say 'no, hang on a minute, here you know you've got
it a little bit wrong' or 'it's not quite like that'
(SarahFG, 1005-1008).


The capacity for assertiveness however, was placed in a context of age, as well as professional status (i.e. being a psychologist)(c.f. power/knowledge). So, education and age were constructed as assisting an 'assertive' subject position, in order to voice dissent and make corrections in terms of the meanings of the client-generated metaphor as misrepresented by the therapist. In the absence of these conditions assertiveness was deemed difficult:

I was thinking when you were talking you described
yourself as feisty and sort of being empowered within
that relationship [ ] so I was thinking when I was in therapy
I was younger than you are and I didn't know anything at
all about psychology, I wasn't a psychologist (laughs)
(LindaFG, 1033-1035).


Though none of the client participants talked about physically leaving the therapy space when positioned in unfavourable ways, they nonetheless talked about the possible employment of other discursive and interactional resistance and protest strategies to these positionings. In this section I explore a number of 'acts of resistance'.

a) Making personal comments and asking questions


Mastache (2003) reports acts of successful client resistance to power positionings, such as asking the therapist personal questions (op. cit). In this research, the strategy of making personal comments, we are told in the extract below, is unyielding of positive results, such as the egality of the therapeutic relationship, as the client attempts to position both herself and her therapist as equals. Though this construction can also be viewed as a device that manages stake on the part of the client who escapes issues of responsibility by reversing the tables on the therapist, we are told here that as a strategy to bring about egalitarian equilibrium it is unsuccessful, as the therapist is disproving of it. In the extract that follows Jo makes a comment on the therapist's tan and ponders a question that concerns the therapist's holiday, just as reported by Mastache (2003). The difference is that while in Mastache's research the therapist reinforces a democratic climate and answers the client's questions, even interweaving personal narratives (op. cit), the therapist in my research is said to be 'disapproving'. Jo evokes a family discourse where she positions herself as a child and the therapist as a parent (e.g. "you're not allowed", "she was very disapproving") who needs to ask for permission for her actions, rather than, as an adult, initiate a discussion:


I really hated that there were no pleasantries at all
and you know you're not allowed to ask say oh did
you have a nice holiday or anything like that because
she'd really cut you dead if you made some sort of
remark and after our two weeks holiday, she and I
were both off at the same time and she came back
with a suntan and I just made a comment and she
was very disapproving about it (Jo, 361-366).


b) Repetition


Another discursive strategy of resistance is the persistent recapitulation of issues in therapy as a response to the therapist's withholding. In the next example, Jo says she persisted in her attempts to elicit a response or feedback from her therapist:

very often I think she understood, she just wasn't
letting me know she understood, so I wasted a lot of
time talking about the same thing over and over again
trying to get a reaction' (Jo, 384-386).


Repetition as a strategy of resistance is also evident in the next quote:

yes it is, it is like riding a horse, it is exactly like riding a horse' (Jo, 314)


c) Giving feedback


A strategy of giving feedback to the therapist is an attempt to redress power imbalances. In the extract below, the therapist is said to resist a new order of things when the client offers unfavourable feedback about the therapeutic relationship by ending the conversation ('oh thanks for telling me that'). Her refusal to engage with this issue and withholding stance can be interpreted as acts of resistance to the client's resistance:

and then at the end I told her this I told her I haven't
really communicated, we haven't really communicated
and she just said oh thanks for telling me that and that
was it really (Jo, 386-391).


d) Rejection


Another act of withholding, this time on the part of the client, also suggests that by rejecting everything, Elaine resists being positioned as a responsible and autonomous agent. She does not want answers, she does not want guidelines, she does not want help and she does not want to be the one to ask for these things either:


I believe that although the therapist should not give
answers or guidelines and answers to what you should
or should not do I believe that occasionally the therapist
should help a bit the client in saying the things that they
have to say, I mean not help but make things easier.
I remember my therapist you know it was like half an
hour of the session and we were just staring at each
other and it was like I'm not gonna say anything until
she says something you know I had gone in angry I
don't want help, or guidelines or answers, I would have
liked more of a challenge so I say things
(Elaine, 554-564).


d) Going defensive


Another withholding strategy is for the client to go defensive. We are not told exactly what this entails, however it is resisting being positioned in an objectifying way rather than in a relational way, such as in the case of a passive therapist who, acting like a mirror, necessitates a very active client:

I suppose having a bit of a therapy training myself I was
rather aware of the techniques and it made me feel a
little bit unsafe the way they make themselves very bland
and try to get you to project and I think I went very defensive
(Rhona, 59-62).


e) Correcting


An egalitarian strategy of resistance to an otherwise unequal balance of power, where the therapist pursues a line of a misinterpretation of metaphor, is for the client to 'speak up'. As in 'giving feedback', the 'assertive' client is a client who does 'correcting' as a strategy of challenging and redressing power positionings, including the misconstruing of meaning. Through this strategy, the client exercises control over meaning:

when you talk about only metaphor or when you talk about
you know sort of the therapist coming back to the metaphor
and not feeling comfortable with that I think I would sort of
say no hang on a minute here (SarahFG, 999-1001).


Implications for Therapeutic Practice


Reflecting upon these power-related aspects of metaphor, I want to advance an argument of 'usefulness', which consists of a utilitarian angle, offering practical recommendations to therapists. The discussion that follows is concerned with this utilitarian argument and also advances a political agenda for therapy, which has as a main therapeutic aim the empowerment of the client. By 'empowerment' I mean both within the context of therapy (i.e. assuming therapy relies inherently on an imbalance of power) and beyond, in a social context. The issue of power in therapy has been well documented in the therapy literature (e.g. Killikelly, 1995; Webster, 1995) and the issue of power imbalance as endemic to the therapeutic encounter is now generally accepted. Therefore, Carswell and Macgraw's (2001) suggestion of a political agenda for therapy is timely. The agenda can choose to be politically empowering and subverting by effecting change or politically conservative whereby it enforces and supports societal structures. The paper attempts to feed into this kind of political and empowering agenda. Carswell and Macgraw (2001) also comment on the double bind therapists may find themselves in, when even as they work to empower clients they are themselves dis-empowered by the institutions in which they work. Aside from issues related to the organisational and institutional environments as contexts of therapeutic work, often conservative and resistant to a political agenda for therapy, the authors also provide the example of therapeutic stories, usually narrated in the therapy literature from the therapist's point of view, while the client as a source of information for the therapeutic relationship is ignored. Social constructionist thinking and approaches to therapy identify familiarity, democracy and equality as desirable characteristics of a therapeutic environment (Mastache, 2003; Anderson, 1997; Hoffman, 1990). Mastache (2003) has looked at the details of therapy talk and explored ways in which the above democratic features become visible in 'institutional talk' when this overlaps with 'ordinary talk' (i.e. such as 'holiday talk' initiated by the client). The overlap between the two ways of talk is concerned with a change in the relationship of power between therapist and client (Mastache, 2003). This represents a departure from the view that the two kinds of talk are different and almost mutually exclusive (Silverman, 1997; Drew and Heritage, 1992). Discursive displays such as the therapist's 'self-disclosure', the client's' self-diagnosis' and the client 'asking questions' are all examples of unexpected ways of talk in therapy, which promote a more democratic and egalitarian environment (Mastache, 2003). These feature increase with a certain kind of therapeutic environment. These findings that suggest the client is active also oppose the traditional view that clients are passive recipients in therapy or have a position limited to telling the therapist their problems (Mastache, 2003). Traditionally, the questions of the client questions can be construed by the therapist as 'resistance'. By answering questions directly, providing some detail, the therapist is promoting an egalitarian environment for therapy.

Clients to therapy have reported that familiarity, feeling comfortable and relaxed and a relaxed, informal environment are all important aspects of therapy (Mastache, 2000; Anderson, 1997). The present research supports and adds to these findings. In this research clients represented a therapeutic environment that creates, promotes and sustains power relations as unhelpful and undesirable (e.g. the signifying environment). Furthermore, metaphor use in a therapeutic context has been largely represented as an arena for client-therapist conflict and inequality. Where meaning was arrived at non-collaboratively the therapist shuts down its exploration rather than opening it up in an act of co-construction, uses metaphor as a silencing device or imposes his or her own interpretation of meaning on the client's metaphor, thereby making it' something different and unrecognisable for the client. This, we are told, is the process that takes place instead of processes of clarification or co-construction of meaning (e.g. see the high-jacked metaphor). The physical set-up of the therapy environment is also important. Rather than promoting power inequalities (e.g. such as in the signifying environment), due attention and thought might instead promote the relaxed, informal and egalitarian atmosphere clients say they want.

Not all metaphor use has been discussed within a context of un-helpfulness or oppression. Other uses of metaphor as an educational device (e.g. explanatory of processes, promoting self-help in the form of books, etc.) or where therapist and client were equal, unknowing parties in the co-construction and open exploration of meaning, have been constructed as helpful and empowering. As metaphors make certain worldviews available and have implications through positionings, the therapist could be aware of those and use metaphors (i.e. in the case of therapist-generated metaphors) that do not compromise the client by offering unfavourable or unequal subject positions (e.g. the re-parenting metaphor). Moreover, open-shaped metaphors that reflect a sort of progress or movement (e.g. journey, metaphors of growth or expansion, etc.) or spatial metaphors (e.g. metaphors of landscapes) offer many possibilities and could be preferred ways of using metaphor to describe for example the process of therapy or a psychological state. I am attempting here to draw attention to the importance of the therapist's awareness of the implications of metaphors (i.e. the worldview and positions offered within that, as well as their desirability or appropriateness), rather than be prescriptive as to how metaphors could be used or indeed should be used.

The training of counselling or clinical psychologists could also reflect the ever-presence of metaphor. A number of therapists in the research commented that they had mostly become aware of metaphor use in therapy in their own practice rather than in their training. Where metaphor work in the training was mentioned, it was in the context of having a small, peripheral role if any, or else being discussed in relation to the training itself (e.g. metaphors of group process in training, issues of transference/counter-transference of students and lecturers, etc.), rather than ways of working with metaphor with clients in therapy. Moreover, if all language is metaphorical, but metaphors become reified as versions of reality as we speak them (i.e. through the reification offered by language itself), as therapists we would surely benefit from an awareness and a (joint) decision as to what versions of reality is helpful or appropriate to advance with our clients. The client's own direction in this would be valuable. In the act of co-construction, different metaphors can be created and explored for the fit they provide with the client's worldview, as well as others be created, which might offer other, alternative ways of looking at the world, which the client may find helpful or useful. Where metaphors don't fit' or are outgrown, they are simply and lightly discarded in favour of others. Importantly, as a process of collaboration it would bring the therapist and the client together as a team. In other words, metaphor work would be relational and contextual, as part of the therapy process and not a technique to be done on clients.

Summary and Concluding Remarks

In this paper, I explored themes of power in the accounts of clients, having analysed these accounts with a Foucauldian version of discourse analysis. A Foucauldian approach necessitates exploration of this theme as it holds that institutions like therapy maintain and reproduce power relations. Clients' constructions included metaphor as a silencing device in the hands of the therapist, whereby metaphor is used strategically, with varying degrees of success, in order to resist a particular worldview of the client and to impose another, that is favoured by the therapist. The high-jacked metaphor' is another construction that works in this way, silencing the client. As such it has the effect of alienating the client, since the meaning is not arrived at collaboratively; rather, the therapist takes the ball and runs with it (to use a metaphor), not checking out meanings with the client. This results in taking the meaning into a different direction that than intended by the client. This kind of use of client metaphors by the therapist can also take the form of another oppressive strategy that of asking probing questions and legitimises the position to be able to do that. As the therapist does not receive the metaphor as a metaphor, but rather takes it literally, the meaning again not negotiated but taken for granted by the therapist, the therapist assumes the client is talking about something literal and responds with probing psychologising questions. This has the effect of positioning the client as mentally disturbed' and has then to do a lot of discursive work to take him/herself out of that position. The high-jacked metaphor' as an unequal position of power also legitimises the asking of probing questions by the therapist and compromises the position of the client. The environment as a sign of power hierarchies and positions is another example of metaphor at work, this time not as a conscious technique used by the therapist, but as a meta-communication and an institutional method of control. In this case, the physical arrangement of the therapy space spells out the respective positions to be occupied by therapist and client. The therapist, having a bookcase behind her is expected to function as the ideal knower (a position inherently powerful) and the client as passive and emotionally discharging, as signified by the empty bin and box of tissues next to her seat. Other such signifying, metaphorical practices for power positions are objects in the therapy environment that spell out distance in the social positions occupied by the client and by the therapist, as in displayed photographs of affluence. Metaphor as meta-communication can also take the form of actions and behaviours, such as the therapist following certain scripted behaviour dictated by their profession. This can take the form of behaviours such as leading the way to the therapy room and having the client follow, taking notes and adopting a withholding stance in the process of therapy with little or no personal disclosure, feedback to the client and responses. This stance is usually consistent with the psychoanalytic paradigm, where the therapist aims to be a 'blank slate'. Metaphor, in addition to being strategically used, was also withheld by the client, as a form of reclaiming some power by eschewing a compromised positioning as 'mentally ill'. For example, I showed how some clients withheld metaphors that were anticipated to sound bizarre to the therapist, particularly in the context of the client's history of use of mental health services and the therapist's knowledge of this. A small number of instances that referred to metaphor's use as empowering were also addressed particularly as instruction/guidance and inspiration. In exploring issues of power, I also looked at client positionings that resisted or challenged unequal positions. The client as assertive was discussed in the context of education and maturity (i.e. age). Access to power was therefore deemed as a function of confidence (i.e. the ability to stand up for oneself) and knowledge (i.e. access to other more empowering discourses). Resisting compromised power positions in the absence of these factors was constructed as near impossible. Instead, the clients find themselves in a passive or even helpless position. 'Acts of resistance' constitute a number of strategies employed by the clients in order to challenge the therapist's enforcement of particular unwanted positionings. These acts of resistance' included making personal comments, asking personal questions, repetition, giving feedback, rejection, going defensive and correcting. I argue that it is not metaphor as a technique that is problematic in itself, rather it is a sole instrumentalist view of metaphor that is problematic. For example, the use of metaphor as a technique to get the client to follow instructions, such as in the case of overcoming the client's resistance (Spellman, 1994), rather as a process of meaning construction within the relational context of the therapy process. [5]



References



Anderson, H. (1997). Conversation, language and possibilities: A postmodern approach to therapy. NY: Basic Books.


Anderson, H. and Goolishian, H. (1992). The client is the expert: a not-knowing approach to therapy. In McNamee, S. and Gergen, K. (Eds.), Therapy as social construction. London: Sage.

Bhavnani, K. (1990). What's power got to do with it? Empowerment and social research. In I. Parker and Shotter, J. (1990). Deconstructing social psychology. London: Routledge.


Carswell, M. A. and Macgraw, K. (2001). Embodiment as a metaphor in therapy, Organdi Quarterly, No. 2, February, 1-12. Retrieved April, 2, 2003 from http://www.geocities.com/organdi_revue/

Cheshire, A., Lewis, D. and The Anti-Harassment Team (2004). Young people and adults in a team against harassment: Bringing forth student knowledge and skill. In D. Par‚ and G. Larner (2004, Eds.). Collaborative practice in psychology and therapy. NY: The Haworth Clinical Practice Press.


Cox, M. and A. Theilgaard (1988). Mutative metaphors in psychotherapy : The Aeolian mode. London : Jessica Kingsley.


Drew, P. and Heritage, J. (1992). Talk at work interaction in institutional settings. Cambridge: Cambridge University Press.


Edwards, D. (1997). Discourse and cognition. London: Sage.


Edwards, D. and Potter, J. (1992). Discursive psychology. London: Sage.


Gersie, A. and King, N. (1990). Storymaking in education and therapy. London: Jessica Kingsley Publishers.


Harper, D. (2002a). The tyranny of expert language, Open Mind, Vol. 113, 8-9.


Harper, D. (2002b). Moving beyond the tyranny of experts, Open Mind, Vol. 115, 20-21.


Hoffman, L. (1990). Constructing realities: an art of lenses, Family Process, 29 (1), March, 1-12.


Jaworski, A. and Coupland, N. (1999). The discourse reader. London: Routledge.


Killikelly, T. (1995). Whose dream is it anyway?, Self and Society, May, 23(2).


Kopp, R.R. (1995). Metaphor therapy-Using client-generated metaphors in psychotherapy. New York: Brunner/Mazel.

Mastache, C. (2003). Clients' questions in therapy talk, unpublished paper presented at the 1st International Conference of Critical Psychology, 27-31 August, 2003, Bath.

Mastache, C. (2000). La co-construcción del proceso terapéutico: la perspectiva del paciente y la perspectiva` del terapeuta. Facultad de Psicología, UNAM, México. Unpublished MSc. thesis in Mastache, C. (2003).

Parker, I. (1992). Discourse dynamics: Critical analysis for social and individual psychology. London: Routledge.


Potter, J. (1996). Representing reality: Discourse, rhetoric and social construction. London: Sage.


Potter, J. and Wetherell, M. (1987). Discourse and social psychology: beyond attitudes and behaviour. London: Sage.

Silverman, D. (1997). Discourses of counselling: HIV counselling as social interaction. London: Sage.


Simpson, A. (1997). "It's a Game! The construction of gendered subjectivity'. In R. Wodak (Ed.), Gender and discourse. London: Sage

Spellman, D. (1994). Beyond instrumentalism: the use of metaphor in family therapy. Human Systems: The Journal of Systemic Consultation and Management, 5, 83-95.


 Webster, R. (1995). Why Freud was wrong: Sin, science and psychoanalysis. London: Fontana.

White, M. and Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.

Willig, C. (2004). Discourse analysis and health psychology. In M. Murray (Ed.), Critical Health Psychology. NY: Palgrave Macmillan.

Willig, C. (2000). A discourse-dynamic approach to the study of subjectivity in health psychology, Theory and Psychology, Vol. 10(4): 547-570.


Notes


[1] A version of this paper was presented at the 1st International Conference of Critical Psychology at Bath, UK, August 2003

[2] Read, 'power issues'

[3] Names and numbers in parentheses represent a participant's pseudonym and extract line number

[4] FG denotes a focus group participant

[5] I wish to acknowledge the invaluable aid and support of my supervisor, Dr. Carla Willig, during my Ph.D and for her feedback on a draft of this paper


Biographical Note:

Dr. Dafni Milioni is a Counsellor and Dramatherapist. She obtained her Ph.D in Psychology (2004) from City University, London, conducting discourse analytic research in the borders of counselling psychology/social critical psychology. Research interests include institutional and interpersonal power and possibilities for resistance, therapists’ and clients’ subjectivities, therapeutic environments and the study of spirituality.


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